盡情享受. Let Oneself Go. TravelCare Insurance

Transcription

1 盡情享受 Let Oneself Go TravelCare Insurance

2 TravelCare Insurance TravelCare provides you with comprehensive travel protection for leisure and business trips. Medical Expenses, Worldwide Emergency Services, Hospital Cash Allowance, Personal Accident, Major Burns, Personal Money, Baggage, Personal Liability, Travel Delay, Cancellation and Curtailment of Trip are all included. For details, please refer to the section of Coverage below. Product Highlights No excess for all benefits 24-hour Worldwide Emergency Assistance Services Cover for leisure and amateur sports activities including winter sports, bungee jumping, hiking, rock climbing, horse riding, scuba diving and other water sports etc Cover for personal accident and medical related claims caused by act of terrorism Premium is calculated on daily basis according to the exact length of your trip Unlimited number of children for Individual & Children or Family Plan Free automatic extension up to 10 days in case of unavoidable delay of the stipulated itinerary Coverage Cover 1. Medical Expenses 2. Hospitalization or Quarantine Cash Allowance 3. Worldwide Emergency Assistance Service Benefits Maximum Limit (HK$) Plan A Plan B a) Medical Expenses the cost of qualified medical $1,000,000 $500,000 treatment, surgery and hospitalisation arising from sickness or accidental injury. b) Follow-up Expenses - medical, hospital and treatment expenses reasonably incurred within 90 days of the Insured Person s return to the place of origin from overseas up to HK$100,000 (Including Chinese bone setting in Hong Kong up to HK$3,000 with a maximum daily limit per visit HK$200). a) Overseas Hospitalization - HK$500 for each complete day in hospital to meet Insured Person's extra expenses. b) Compulsory Quarantine - HK$500 for each complete day during the journey or 7 days upon return to Hong Kong. a) Emergency Medical Evacuation and Repatriation - send the Insured Person to the nearest facility capable of providing adequate medical care, and repatriate the Insured Person back to Hong Kong if the physician determines that it is necessary. b) Guarantee of Hospital Admission Deposits - for hospital admittance fees on behalf of the Insured Person. c) Additional Costs of Accommodation - for an Insured Person's family member or travelling companion when such costs arise from hospitalization or delay due to a serious medical condition of the Insured Person. d) Compassionate Visit and Hotel Accommodation - up to 2 immediate family members, includes travelling cost to join the Insured Person who is confined in hospital for more than 3 days or dies abroad. e) Return of Minor Children - reasonable additional accommodation and travelling expenses, such as a one-way economy airfare for the return of unattended Insured Person's children (aged below 18) to Hong Kong. f) Repatriation of Mortal Remains - transportation charges for repatriation of the mortal remains to Hong Kong. g) Unexpected Return in the Event of the Death of a Close Relative - return economy class airfare for unexpected return to Hong Kong following the death of a close relative. h) Other Assistance - including telephone medical advice, emergency travel service assistance or legal referral etc. Worldwide Emergency Assistance Service is arranged by International SOS (HK) Limited. $10,000 $5,000 Fully Covered Fully Covered $40,000 $40,000 Included Included 4. Personal Accident 5. Baggage 6. Baggage Delay 7. Personal Money 8. Loss of Travel Document 9.Travel Delay 10.Cancellation Charge Accidental death / permanent total disablement / total and permanent loss of sight in one or both eyes / loss by severance or permanent and total loss of use of one or more limbs. (Death benefit for children under 18 years old and for person over 70 years old shall not exceed HK$300,000.) Major Burns Suffering of Third Degree Burns with burnt areas equal to or greater than 5% of head or 10% of total body surface area. Credit Card Protection In the event of accidental death of the Insured Person during the journey, the outstanding balance of the Insured Person's credit card as at the date of accident will be covered. Loss, physical breakage of damage directly resulting from accident, theft, burglary, or mishandling by carriers to the Insured Person s baggage or personal property carry-on. The limit for each item, pair or set shall be HK$3,000. Emergency purchases of essential items of toiletries and clothing and the additional travelling cost to get back the baggage consequent upon temporary deprivation of baggage for at least 6 hours from the time of arrival at destination abroad due to delay or misdirection in delivery. Loss of cash, banknotes and travellers cheques arising from theft, burglary or robbery. Cost of obtaining replacement air tickets, travel document, travel expenses and accommodation incurred to obtain such replacement arising from theft, burglary, robbery and accidental loss (Reimbursement is limited to HK$2,000 per day for Plan A or HK$1,000 per day for Plan B). a) Additional Travel Cost - Public transportation expenses necessarily incurred to re-route the trip due to delay or cancellation of airline or other public transportation resulting from serious weather condition, industrial action, hijack or mechanical derangement. b) Cash Allowance - If the Insured Person need not to pay additional transportation expenses in the event of travel delay, the Insured Person will be indemnified at HK$300 for each full 6-hour period delay. (Select either a or b for compensation only.) Reimbursement of irrecoverable prepaid accommodation, tour costs and travel tickets due to cancellation of trip in the event of death, serious sickness or injury of the Insured Person, immediate family members, travel companion or close business partner of the Insured Person, witness summons, jury service, compulsory quarantine of the Insured Person, natural disaster or unanticipated outbreak of epidemic diseases/industrial action, riot/civil commotion at the destination within 7 days before departure date, serious damage to the Insured Person s principal home in Hong Kong arising from fire or flooding within 10 days from the departure date or Black Outbound Travel Alert for the destination is in effect 7 days before the departure date. $1,200,000 $600,000 $200,000 $100,000 $30,000 $15,000 $20,000 $3,000 $1,500 $500 $3,000 $2,000 $20,000 $5,000 $10,000 $2,500 $2,500 $600 $30,000 $5, Curtailment of Trip 12. Loss of Home Contents 13. Personal Liability 14. Rental Vehicle Excess 15. Golfer Hole-in- One Reimbursement of irrecoverable prepaid transport or accommodation charges and additional public transportation expenses incurred to return to Hong Kong due to curtailment of trip in the event of death, serious sickness or injury of the Insured Person, immediate family members, travel companion or close business partner of the Insured Person, natural disaster or unanticipated outbreak of epidemic diseases,industrial action, riot, civil commotion at the destination that prevents the Insured Person from continuing the journey or Black Outbound Alert for the destination is in effect during the journey. The loss of or damage to the contents or personal effects of the Insured Person s principal home as a result of burglary with forcible and violent entry to or exit from the premise whilst the home is unoccupied during the period of travel. Indemnity against legal liability to third party as a result of accidental injury, loss or damage to third party s property during the Period of Insurance. (This benefit does not apply to liability arising from the use or hire of motor vehicle.) If the Insured Person hires a rental vehicle during the journey and is involved in a car accident, or the vehicle is damaged or stolen, the claims excess in the motor insurance policy purchased by the Insured Person will be reimbursed. If the Insured Person achieve a "hole-in-one" at any recognized golf course. $30,000 $5,000 $30,000 $10,000 $3,000,000 $1,500,000 $5,000 $3,000 $3,000 $1,000 Major Exclusions 1. War (whether declared or not), civil war, act of foreign enemies, rebellion, military or usurped power. 2. Nuclear hazards. 3. Acts of Terrorism (Expenses arising from the Personal Accident, Medical Cover, Worldwide Emergency Services, Travel Delay, Cancellation Charges and Trip Curtailment as a result of Acts of Terrorism are covered by TravelCare). 4. Pre-existing condition, congenital and hereditary condition. 5. Suicide, attempted suicide or intentional self-inflicted bodily injuries, insanity, abortion, miscarriage, assigned complications, pregnancy, child-birth, venereal diseases, the use of alcohol or drugs other than those prescribed by a qualified registered physician, dental treatment (unless resulting from accidental bodily injury to sound and natural teeth). 6. Racing (other than on foot) or any sports or games in a professional capacity or where the Insured Person would or could earn income or remuneration from engaging in such sports. 7. Any activities in the air unless an insured person is (i) travelling as a fare paying passenger in a licensed aircraft operated by a recognised airline, or (ii) participating in an activity of which the maneuver or navigation is managed and controlled by another licensed person and the provider of such activity must be authorised by the relevant local authority. 8. Losses which are not reported within 24 hours to the authorities (such as airlines, police) and failure to provide the report certified by the relevant authorities. 9. Pager, Mobile Phone, handheld portable telecommunication equipment, computer equipment (except Lap Top Computer). 10.Personal liabilities arising from use or operation of vehicles, aircraft, watercraft, willful, malicious or unlawful acts. Age Limit Individual-Refers to the Insured Person aged between 18 and 85 Children - Refers to dependent & unmarried children who is/are 6 weeks to 17 years of age travelling with the Insured Person during the entire journey Individual & Children - Refers to Insured Person and his/her children defined above with no limit on number of children Family - Refers to the Insured Person and his/her spouse and children as defined above with no limit on number of children (This summary gives only an outline of the insurance cover. Please refer to the insurance policy for the precise terms and conditions)

3 旅遊保險 保障範圍產品特點

4 TravelCare Insurance Application Form Please complete in BLOCK LETTERS and tick where appropriate. (I) Details of Applicant Full Name of Applicant (Applicant must be aged 18 or above Correspondence Address Contact No. (II) The Person(s) to be Insured Name of Insured Person(s) Mrs. Mr. Flat, Floor, Block Street *HK / Kowloon / NT Relationship Ms. Miss Address Self HKID Card/Passport No., Building District Date of Birth (DD / MM / YY) HKID Card / Passport No. Notes 1. The Applicant warrants that to the best of his / her knowledge and belief no Insured Person is traveling contrary to the advice of any medical practitioner or for the purpose of obtaining medical treatment and that he / she understands that treatment of any pre-existing, recurring or congenital medical conditions are not insured. The Applicant is not aware of any condition cause or circumstance that may necessitate the cancellation or curtailment of the journey as planned. 2. Age Limit: 6 weeks up to the age of 85 (70 for Annual Cover) Children under age of 18 must be accompanied by an adult who is also insured under the same insurance policy In the event of the death of an Insured Person, the beneficiary shall be that person s estate according to the laws of Hong Kong. 5. This Insurance is only valid for travel originating from and returning to Hong Kong. 6. The maximum duration of journey is 180 days for single trip cover and 90 days for annual cover Except for annual cover, no refund of premium is allowed once the insurance certificate has been issued. 5. (III) For Single Trip Period of Insurance : Covered Plan : From Total days DD MM YY DD MM YY Plan A Plan B (Please tick the appropriate box) Total Premium : HK$ (excluding insurance levy) Payment Method Cheque should be crossed and made payable to FWD General Insurance Company Limited Bank of Communications Cheque Visa MasterCard FWD Credit Card FWD Credit Card No. (IV) For Annual Cover Cardholders Name Card Expiry Date Period of Insurance : Occupation : From DD MM YY DD MM YY both dates inclusive (please state occupation of all Insured Persons) M Y I hereby authorize FWD General Insurance Company Limited to charge my credit card account specified for this insurance. Covered Plan : Plan A Plan B (Please tick the appropriate box) Total Premium : HK$ (excluding insurance levy) Cardholders Signature Date * The payer and the policyholder must be the same person. No third party payment is accepted. Levy collected by the Insurance Authority will be imposed on the relevant policy at the applicable rate. For further information, please visit or contact: (852) (852)

5 Single Trip Premium Table (HK$) No. of Day , , , , , , , , , , , , , , , , ,638 1, , ,688 1, , ,738 1, , ,788 1, , ,838 1, , ,888 1, , ,938 1,193 Each additional day up to 180 days Insurance levy is not included in the above premium Annual Cover Premium Table (HK$) Annual Cover not exceeding 90 days each trip Individual Plan A Plan B Individual Plan A Plan B Individual & Children Plan A Plan B Family Plan A Plan B Individual & Children/Family Plan A Plan B 1,800 1,300 3,600 2,600 Insurance levy is not included in the above premium Insurance Levy Rate Table 保費徵費表 Date of Policy Inception From 1 Jan 2018 till 31 Mar 2019 From 1 Apr 2019 till 31 Mar 2020 Rate Cap (HK$) Date of Policy Inception Rate From 1 Apr 2020 till 31 Mar % 2, % 0.060% 3,000 From 1 Apr 2021 onwards 0.100% Cap (HK$) Levy collected by the Insurance Authority will be imposed on the relevant policy at the applicable rate. For further information, please visit or contact: (852) (852) Notes: Individual - refers to the Insured Person aged between 18 and 85 (70 for Annual Cover) Children - refers to dependent & unmarried children who is / are 6 weeks to 17 years of age travelling with the Insured Person during the entire journey Individual & Children - refers to Insured Person and his / her children defined above with no limit on number of children Family - refers to the Insured Person and his / her spouse and children as defined above with no limit on number of children 4,250 5,000 FWD General Insurance Company Limited Personal Information Collection Statement ("PICS") 1. From time to time, it is necessary for you to supply FWD General Insurance Company Limited (the "Company") or agents and representatives acting on its behalf with personal information and particulars in connection with our services and products. Failure to provide the necessary information and particulars may result in the Company being unable to provide or continue to provide these services and products to you. 2. The Company may also generate and compile additional personal data using the information and particulars provided by you. All personal data collected, generated and compiled by the Company about you from time to time is collectively referred to in this PICS as "Your Personal Data". 3. "Your Personal Data" will also include personal data relating to your dependents, beneficiaries, authorised representatives and other individuals in relation to which you have provided information. If you provide personal data on behalf of any person you confirm that you are either their parent or guardian or you have obtained that person's consent to provide that personal data for use by the Company for the purposes set out in this PICS. 4. As detailed in this PICS, Your Personal Data may also be processed by the Company's subsidiaries, holding companies, associated or affiliated companies and companies controlled by or under common control with the Company (collectively, "the Group") 5. The purposes for which Your Personal Data may be used are as follows: (i) providing our services and products to you, including administering, maintaining, managing and operating such services and products; (ii) processing, assessing and determining any applications or requests made by you in connection with our services or products and maintaining your account with the Company; (iii) developing insurance and other financial services and products; (iv) developing and maintaining credit and risk related models; (v) processing payment instructions; (vi) determining any indebtedness owing to or from you, and collecting and recovering any amount owing from you or any person who has provided any security or other undertakings for your liabilities; (vii) exercising any rights that the Company may have in connection with our services and/or products; (viii) carrying out and/or verifying any eligibility, credit, physical, medical, security, underwriting and/or identity checks in connection with our services and products; (ix) any purposes in connection with any claims made by or against or otherwise involving you in respect of any of our services or products, including, making, defending, analysing, investigating, processing, assessing, determining, responding to, resolving or settling such claims; (x) performing policy reviews and needs analysis (whether or not on a regular basis); (xi) meeting disclosure obligations and other requirements imposed by or for the purposes of any laws, rules, regulations, codes of practice or guidelines (whether applicable in or outside Hong Kong) binding on the Company or any other member of the Group, including making disclosure to any legal, regulatory, governmental, tax, law enforcement or other authorities (including for compliance with sanctions laws, the prevention or detection of money laundering, terrorist financing or other unlawful activities) or to any self-regulatory or industry bodies such as federations or associations of insurers; (xii) for statistical or actuarial research undertaken by the Company or any member of the Group; and (xiii) fulfilling any other purposes directly related to (i) to (xii) above. 6. Your Personal Data will be kept confidential, but to facilitate the purposes set out in paragraph 5 above, the Company may transfer, disclose, grant access to or share Your Personal Data with the following: (i) other members of the Group; (ii) any person or company carrying on insurance-related and/or reinsurance-related business which is engaged by the Company in connection with the Company's business; (iii) any physicians, hospitals, clinics, medical practitioners, laboratories, technicians, loss adjustors, risk intelligence providers, claims investigators, legal advisors and/or other professional advisors engaged in connection with the Company's business; (iv) any agent, contractor or service provider providing administrative, distribution, credit reference, debt collection, telecommunications, computer, call centre, data processing, payment processing, printing, redemption or other services in connection with the Company's business; and/or (v) any official, regulator, ministry, law enforcement agent or other person (whether within or outside Hong Kong) to whom the Company or another member of the Group is under an obligation or otherwise required or expected to make disclosures under the requirements of any law, rules, regulations, codes of practice or guidelines (whether applicable in or outside Hong Kong). 7. Your Personal Data may be transferred or disclosed to any assignee, transferee, participant or sub-participant of all or any substantial part of the Company's business. 8. The Company is only allowed to (i) use Your Personal Data in direct marketing; or (ii) provide Your Personal Data to another person or company for its use in direct marketing, if you provide your consent or do not object in writing. 9. In connection with direct marketing, the Company intends: (i) to use your name, contact details, services and products portfolio information, financial background and demographic data held by the Company from time to time in direct marketing to market the following classes of services and products offered by the Company, other members of the Group and/or Our Business Partners (being providers of the product and services described below) from time to time: (ii) a. insurance services and products; b. wealth management services and products; c. pensions, investments, brokering, financial advisory, credit and other financial services and products; d. health-check and wellness services and products; e. media, entertainment and telecommunications services; f. reward, loyalty or privileges programmes and related services and products; and g. donations and contributions for charitable and/or non-profit making purposes; and to provide your name and contact details to any members of the Group and/or Our Business Partners for their use in direct marketing the classes of services and products described in paragraph 9(i) above (including, in the case of Our Business Partners, for money or other commercial benefit). The Company intends to send you marketing communications or materials and use Your Personal Data in accordance with paragraphs 8 & 9 above. If you do NOT agree to receive such marketing communications or the Company s intended use of Your Personal Data, you may write to the Corporate Data Protection Officer of the Company at the address below to opt out from direct marketing at any time: Corporate Data Protection Officer FWD General Insurance Company Limited 1st Floor, FWD Financial Centre, 308 Des Voeux Road Central Hong Kong 10. To facilitate the purposes set out in paragraphs 5 and 9 above, the Company may transfer, disclose, grant access to or share Your Personal Data with the parties set out in paragraphs 6 and 9(ii) and you acknowledge that those parties may be based outside Hong Kong and that Your Personal Data may be transferred to places where there may not be in place data protection laws which are substantially similar to, or serve the same purposes as, the Personal Data (Privacy) Ordinance. 11. Under the Personal Data (Privacy) Ordinance you have the right to request access to Your Personal Data held by the Company and request correction of any of Your Personal Data which is incorrect and the Company has the right to charge you a reasonable fee for processing and complying with your data access request. 12. Requests for access to or correction of Your Personal Data should be made in writing to the Corporate Data Protection Officer of the Company at the address above. Should you have any queries, please do not hesitate to call our Customer Service Hotline on In case of discrepancies between the English and Chinese versions of this PICS, the English version shall apply and prevail. 14. The Company reserves the right, at any time effective upon notice to you, to add to, change, update or modify this PICS. Jan 2018

6 FWD General Insurance Company Limited Personal Information Collection Statement ("PICS") 1. From time to time, it is necessary for you to supply FWD General Insurance Company Limited (the "Company") or agents and representatives acting on its behalf with personal information and particulars in connection with our services and products. Failure to provide the necessary information and particulars may result in the Company being unable to provide or continue to provide these services and products to you. 2. The Company may also generate and compile additional personal data using the information and particulars provided by you. All personal data collected, generated and compiled by the Company about you from time to time is collectively referred to in this PICS as "Your Personal Data". 3. "Your Personal Data" will also include personal data relating to your dependents, beneficiaries, authorised representatives and other individuals in relation to which you have provided information. If you provide personal data on behalf of any person you confirm that you are either their parent or guardian or you have obtained that person's consent to provide that personal data for use by the Company for the purposes set out in this PICS. 4. As detailed in this PICS, Your Personal Data may also be processed by the Company's subsidiaries, holding companies, associated or affiliated companies and companies controlled by or under common control with the Company (collectively, "the Group") 5. The purposes for which Your Personal Data may be used are as follows: (i) providing our services and products to you, including administering, maintaining, managing and operating such services and products; (ii) processing, assessing and determining any applications or requests made by you in connection with our services or products and maintaining your account with the Company; (iii) developing insurance and other financial services and products; (iv) developing and maintaining credit and risk related models; (v) processing payment instructions; (vi) determining any indebtedness owing to or from you, and collecting and recovering any amount owing from you or any person who has provided any security or other undertakings for your liabilities; (vii) exercising any rights that the Company may have in connection with our services and/or products; (viii) carrying out and/or verifying any eligibility, credit, physical, medical, security, underwriting and/or identity checks in connection with our services and products; (ix) any purposes in connection with any claims made by or against or otherwise involving you in respect of any of our services or products, including, making, defending, analysing, investigating, processing, assessing, determining, responding to, resolving or settling such claims; (x) performing policy reviews and needs analysis (whether or not on a regular basis); (xi) meeting disclosure obligations and other requirements imposed by or for the purposes of any laws, rules, regulations, codes of practice or guidelines (whether applicable in or outside Hong Kong) binding on the Company or any other member of the Group, including making disclosure to any legal, regulatory, governmental, tax, law enforcement or other authorities (including for compliance with sanctions laws, the prevention or detection of money laundering, terrorist financing or other unlawful activities) or to any self-regulatory or industry bodies such as federations or associations of insurers; (xii) for statistical or actuarial research undertaken by the Company or any member of the Group; and (xiii) fulfilling any other purposes directly related to (i) to (xii) above. 6. Your Personal Data will be kept confidential, but to facilitate the purposes set out in paragraph 5 above, the Company may transfer, disclose, grant access to or share Your Personal Data with the following: (i) other members of the Group; (ii) any person or company carrying on insurance-related and/or reinsurance-related business which is engaged by the Company in connection with the Company's business; (iii) any physicians, hospitals, clinics, medical practitioners, laboratories, technicians, loss adjustors, risk intelligence providers, claims investigators, legal advisors and/or other professional advisors engaged in connection with the Company's business; (iv) any agent, contractor or service provider providing administrative, distribution, credit reference, debt collection, telecommunications, computer, call centre, data processing, payment processing, printing, redemption or other services in connection with the Company's business; and/or (v) any official, regulator, ministry, law enforcement agent or other person (whether within or outside Hong Kong) to whom the Company or another member of the Group is under an obligation or otherwise required or expected to make disclosures under the requirements of any law, rules, regulations, codes of practice or guidelines (whether applicable in or outside Hong Kong). 7. Your Personal Data may be transferred or disclosed to any assignee, transferee, participant or sub-participant of all or any substantial part of the Company's business. 8. The Company is only allowed to (i) use Your Personal Data in direct marketing; or (ii) provide Your Personal Data to another person or company for its use in direct marketing, if you provide your consent or do not object in writing. 9. In connection with direct marketing, the Company intends: (i) to use your name, contact details, services and products portfolio information, financial background and demographic data held by the Company from time to time in direct marketing to market the following classes of services and products offered by the Company, other members of the Group and/or Our Business Partners (being providers of the product and services described below) from time to time: (ii) a. insurance services and products; b. wealth management services and products; c. pensions, investments, brokering, financial advisory, credit and other financial services and products; d. health-check and wellness services and products; e. media, entertainment and telecommunications services; f. reward, loyalty or privileges programmes and related services and products; and g. donations and contributions for charitable and/or non-profit making purposes; and to provide your name and contact details to any members of the Group and/or Our Business Partners for their use in direct marketing the classes of services and products described in paragraph 9(i) above (including, in the case of Our Business Partners, for money or other commercial benefit). The Company intends to send you marketing communications or materials and use Your Personal Data in accordance with paragraphs 8 & 9 above. If you do NOT agree to receive such marketing communications or the Company s intended use of Your Personal Data, you may write to the Corporate Data Protection Officer of the Company at the address below to opt out from direct marketing at any time: Corporate Data Protection Officer FWD General Insurance Company Limited 1st Floor, FWD Financial Centre, 308 Des Voeux Road Central Hong Kong 10. To facilitate the purposes set out in paragraphs 5 and 9 above, the Company may transfer, disclose, grant access to or share Your Personal Data with the parties set out in paragraphs 6 and 9(ii) and you acknowledge that those parties may be based outside Hong Kong and that Your Personal Data may be transferred to places where there may not be in place data protection laws which are substantially similar to, or serve the same purposes as, the Personal Data (Privacy) Ordinance. 11. Under the Personal Data (Privacy) Ordinance you have the right to request access to Your Personal Data held by the Company and request correction of any of Your Personal Data which is incorrect and the Company has the right to charge you a reasonable fee for processing and complying with your data access request. 12. Requests for access to or correction of Your Personal Data should be made in writing to the Corporate Data Protection Officer of the Company at the address above. Should you have any queries, please do not hesitate to call our Customer Service Hotline on In case of discrepancies between the English and Chinese versions of this PICS, the English version shall apply and prevail. 14. The Company reserves the right, at any time effective upon notice to you, to add to, change, update or modify this PICS. Jan 2018

7 Important Notes The Applicant (i.e. You are) is required to disclose all material facts which you know FWD General Insurance Company Limited (the Company ) as an insurer would regard them as likely to influence the acceptance and assessment of this proposal. If you are in doubt whether certain facts are material you should disclose them. We recommend you to keep a record (including a copy of completed proposal) for your future reference of all information given. Providing correct answers and making sure we are informed is for your own protection, as failure to disclose such information may mean that your policy will not provide with the cover you require and may even invalidate the policy altogether. FWD General Insurance Company Limited 9/F., FWD Financial Centre, 308 Des Voeux Road Central, Hong Kong T F

8 Declaration I/WE HEREBY DECLARE AND AGREE THAT: 1. The information and particulars provided on this application form are accurate, true and complete and are given to the best of my knowledge and belief. I/We have not withheld any material information and accept that this application and declaration shall form the basis of the contract between the Company and me/us. I hereby acknowledge that failure to supply true and accurate answers to this application or inform the Company of all material information about this application may render the the Company unable to accept or process this application or the insurance policy void. 2. The insurance coverage applied for shall only take effect when this application has been accepted by the Company and I/We have paid the required premium. 3. (If applicable) I/We have obtained the authorisation from the insured person to provide the information requested in this application and to deal with and receive or request information concerning the insured person from the Company in relation to any matters arising from this application. I/We further acknowledge that the insured person has been explicitly informed and agrees that his/her personal data will be transferred to the Company for the purpose of this application and has been informed of his/ her rights under the Personal Data (Privacy) Ordinance. 4. I/we have read, understood and accepted the PICS. The Company intends to send you marketing communications or materials and use your Personal Data in accordance with paragraphs 8 & 9 of the PICS. If you do not agree to receive such marketing communications or the Company s intended use of your Personal Data, please tick below to exercise your right to opt-out. Opt-out marketing communications or materials and the Company s intended use of my personal data Where the Applicant(s) has/have an Insurance Broker: I/We understand, acknowledge and agree that, as a result of the purchasing and taking up the policy by me/us, with the policy issued by the Company, the Company will pay my/our authorized insurance broker commission during the continuance of the policy including renewals, for arranging the said policy. (If applicable) Where the applicant is a body corporate, I/We am/are the authorized person(s) signing on behalf of the applicant and I/We further confirm to the Company that I/We am/are authorized to do so. I/We understand that the above agreement is necessary for the Company to proceed with the application. Signature of Applicant / Individual to whom the PICS is given / Name of Agent / Broker/ Technical representative / / Date Account Code Should there be any discrepancy between the English and the Chinese versions of this application form, the English version shall apply and prevail. FWD Hong Kong - Corporate Overview FWD Group spans Hong Kong, Macau, Thailand, Indonesia, the Philippines, Singapore, Vietnam & Japan. In Hong Kong, FWD offers life and medical insurance, general insurance, employee benefits, pensions and financial planning services. The life insurance and general insurance operating entities have been assigned strong financial strength ratings by international rating agencies. FWD is focused on creating fresh customer experiences, with easy-to-understand products, supported by digital technology. Through this customer-led approach, FWD aims to become a leading pan-asian insurer that changes the way people feel about insurance. Established in Asia in 2013, FWD is the insurance business of investment group, Pacific Century Group. Our Solutions A quality suite of savings, protection and investment solutions are offered to meet customers evolving needs in different life stages. We continuously enhance our products and services to empower people to live life to the fullest with optimism and confidence. Life and Medical Insurance General Insurance Employee Benefits Pensions Financial Planning FWD has been providing customised services to 534,000 customers with over 730 staff in Hong Kong and Macau (as of 30 June 2017). 富衛香港 - 企業概覽 Get ready to live fwd.com.hk 24-hour Service Hotline Products range from individual life insurance, medical and critical illness protection plans, savings plans, educational reserves for children, retirement plans, investment-linked insurance, and more. A wide spectrum of insurance solutions for individual and corporate customers, including household, motor, personal accident, property, travel, working holiday, overseas study, golf, marine cargo, pet, business pack, office, and more. An array of insurance to protect and retain corporations invaluable assets - employees. Products include group life (total and permanent disablement, accidental death and dismemberment benefits), group medical and group long-term disability income insurance. Customers of Mandatory Provident Fund (MPF) and Occupational Retirement Schemes have the access to a wide range of retirement savings and investment options, and enjoy personalised services of FWD s tied agents. Independent financial advisers help customers analyse their financial situations and propose tailored plans to build and boost customers wealth and investment portfolios. 我們的保險服務